Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mtm Specialist

Organization Family Medicine Physician · NPI 1467188953

Mtm Specialist is a Family Medicine Physician in Bonifay, Florida. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address checks out

123 J Harvey Ethridge St
Bonifay, FL 32425-2104
Phone: (850) 591-9694
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Clinic Pharmacy Taxonomy 3336C0002X

Record details

NPI number1467188953
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Byington — Manager · (850) 591-9694
NPI enumeratedJuly 27, 2022
Last updated in NPPESMarch 8, 2023
Certification dateMarch 8, 2023
Mailing address1423 Conservancy Dr E, Tallahassee, FL 32312-6772

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